Page 29 - Demo
P. 29
SUPPLEMENT-TYPE MEDICAL PLANS | Summary of Benefits | Continued
Supplement-Type Standard Plan
Supplement-Type Enhanced Plan
10% coinsurance, deductible applies.
Member pays $0.
10% coinsurance, deductible applies.
Member pays $0.
$0 copay until 100 days, member pays 100% of all charges beyond 100 days.
Prior hospital stay may be required.
$0 copay until 100 days, member pays 100% of all charges beyond 100 days.
Prior hospital stay may be required.
10% coinsurance, deductible applies.
Member pays $0.
If your Medical Plan has a deductible, it must be met before copayments or coinsurance will apply. See page 42 for details regarding Prescription Drug Plan deductible, copays and coinsurance.
Insurance Trust For Delta Retirees | 2021 Benefits & Resources Guide | 29
URGENT SKILLED NURSING EMERGENCY DOCTOR VISITS CARE FACILITY CARE (PRIMARY & SPECIALISTS)
